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Research paper

Surgical Outcome in Patients with Spontaneous Supratentorial Intracerebral Hemorrhage

By
Vladimir Rendevski ,
Vladimir Rendevski
Dragan Stojanov ,
Dragan Stojanov
Boris Aleksovski ,
Boris Aleksovski
Ana Mihajlovska Rendevska ,
Ana Mihajlovska Rendevska
Aleksandar Chaparoski ,
Aleksandar Chaparoski
Doga Ugurlar ,
Doga Ugurlar
Vasko Aleksovski ,
Vasko Aleksovski
Natalija Baneva ,
Natalija Baneva
Icko Gjorgoski
Icko Gjorgoski

Abstract

Summary The aim of the paper was to evaluate the surgical outcome in patients with spontaneous supratentorial intracerebral hemorrhage (ICH) after surgical intervention, in respect to the initial clinical conditions, age, sex, hemispheric side and anatomic localization of ICH. Thirty-eight surgically treated patients with spontaneous supratentorial intracerebral hemorrhage were included in the study. The surgical outcome was evaluated three months after the initial admission, according to the Glasgow Outcome Scale (GOS). The surgical treatment was successful in 14 patients (37%), whereas it was unsuccessful in 24 patients (63%). We have detected a significant negative correlation between the Glasgow Coma Scale (GCS) scores on admission and the GOS scores after three months, suggesting worse neurological outcome in patients with initially lower GCS scores. The surgical outcome in patients with ICH was not affected by the sex, the hemispheric side and the anatomic localization of ICH, but the age of the patients was estimated as a significant factor for their functional outcome, with younger patients being more likely to be treated successfully. The surgical outcome is affected from the initial clinical state of the patients and their age. The treatment of ICH is still an unsolved clinical problem and the development of new surgical techniques with larger efficiency in the evacuation of the hematoma is necessary, thus making a minimal damage to the normal brain tissue, as well as decreasing the possibility of postoperative bleeding.

References

1.
Grysiewicz RA, Thomas K, Pandey DK. Epidemiology of Ischemic and Hemorrhagic Stroke: Incidence, Prevalence, Mortality, and Risk Factors. Neurologic Clinics. 2008;26(4):871–95.
2.
van Asch CJ, Luitse MJ, Rinkel GJ, van der Tweel I, Algra A, Klijn CJ. Incidence, case fatality, and functional outcome of intracerebral haemorrhage over time, according to age, sex, and ethnic origin: a systematic review and meta-analysis. The Lancet Neurology. 2010;9(2):167–76.
3.
Brott T, Thalinger K, Hertzberg V. Hypertension as a risk factor for spontaneous intracerebral hemorrhage. Stroke. 1986;17(6):1078–83.
4.
Daverat P, Castel JP, Dartigues JF, Orgogozo JM. Death and functional outcome after spontaneous intracerebral hemorrhage. A prospective study of 166 cases using multivariate analysis. Stroke. 1991;22(1):1–6.
5.
Broderick JP, Brott T, Tomsick T, Huster G, Miller R. The Risk of Subarachnoid and Intracerebral Hemorrhages in Blacks as Compared with Whites. New England Journal of Medicine. 1992;326(11):733–6.
6.
MENDELOW A, GREGSON B, FERNANDES H, MURRAY G, TEASDALE G, HOPE D, et al. Early surgery versus initial conservative treatment in patients with spontaneous supratentorial intracerebral haematomas in the International Surgical Trial in Intracerebral Haemorrhage (STICH): a randomised trial. The Lancet. 2005;365(9457):387–97.
7.
Jakubovic R. Intracerebral hemorrhage: toward physiological imaging of hemorrhage risk in acute and chronic bleeding. Frontiers in Neurology. 3.
8.
Broderick JP, Adams HP, Barsan W, Feinberg W, Feldmann E, Grotta J, et al. Guidelines for the Management of Spontaneous Intracerebral Hemorrhage. Stroke. 1999;30(4):905–15.
9.
Wang X, Arima H, Al-Shahi Salman R, Woodward M, Heeley E, Stapf C, et al. Clinical Prediction Algorithm (BRAIN) to Determine Risk of Hematoma Growth in Acute Intracerebral Hemorrhage. Stroke. 2015;46(2):376–81.
10.
Qureshi AI, Mendelow AD, Hanley DF. Intracerebral haemorrhage. The Lancet. 2009;373(9675):1632–44.
11.
Mohr JP, Caplan LR, Melski JW, Goldstein RJ, Duncan GW, Kistler JP, et al. The Harvard Cooperative Stroke Registry. Neurology. 1978;28(8):754–754.
12.
Nakamura T, Xi G, Hua Y, Schallert T, Hoff JT, Keep RF. Intracerebral Hemorrhage in Mice: Model Characterization and Application for Genetically Modified Mice. Journal of Cerebral Blood Flow & Metabolism. 2004;24(5):487–94.
13.
Adeoye O, Broderick JP. Advances in the management of intracerebral hemorrhage. Nature Reviews Neurology. 2010;6(11):593–601.
14.
Broderick JP, Brott TG, Duldner JE, Tomsick T, Huster G. Volume of intracerebral hemorrhage. A powerful and easy-to-use predictor of 30-day mortality. Stroke. 1993;24(7):987–93.
15.
Kobayashi S, Sato A, Kageyama Y, Nakamura H, Watanabe Y, Yamaura A. Treatment of Hypertensive Cerebellar Hemorrhage–Surgical or Conservative Management? Neurosurgery. 1994;34(2):246–51.
16.
Keep RF, Hua Y, Xi G. Intracerebral haemorrhage: mechanisms of injury and therapeutic targets. The Lancet Neurology. 2012;11(8):720–31.

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